Represents an artifact manifest library, providing complete dependency and usage information for an artifact or collection of artifacts. Artifact manifests are used throughout the content development lifecycle to establish version bindings for unversioned canonical references. Prior to release of the artifact(s), the manifest establishes the expansion rules such as code system versions used for expansion of value sets while artifacts are being authored. As part of release, the manifest is used to provide a complete dependency listing, as well as complete binding for all unversioned dependencies referenced in the artifacts so that canonical references can be reliably resolved, ensuring the stability of value set expansions used for evaluation of the artifacts.

Prior to release, artifact(s) should specify code system versions to support stable expansion of value sets during the development phase (also called an expansion profile). Post release, the artifact(s) will specify pinned canonical references for any unversioned canonical references to ensure reliable expansion of value sets. Provisional codes can be specified using the code system version mechanism (i.e. it is not the case that only one code system version can be specified per code system in an expand, and a manifest).

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Indicates that the given code is directly referenced by artifact logic (e.g. as a direct-reference code in CQL). Terminology dependencies used in logic can be collected and reported, typically using the relatedArtifact element with a type of depends-on. However, direct-reference codes cannot be represented in the relatedArtifact element, so this extension provides a means to support communicating direct-reference code dependencies of knowledge artifacts. As with value set dependencies, direct-reference codes may be the terminology target of a data requirement.

Represents a specific logic definition used by the artifact. When logic is referenced from knowledge artifacts, this extension allows each referenced definition to be represented independently so that consumers know which specific expressions are being referenced (i.e. not all expressions in a given library are always used), as well as allows processing applications (such as narrative generation) to easily surface the definitions to provide capabilities such as navigation.

A manifest library must be able to describe the logic definitions it uses.

Specifies a parameters (contained) resource that identifies the options for the CQL-to-ELM translator associated with the CQL content.

When this extension is used with a specific CQL library, it indicates the options that are to be used to translate the CQL to ELM. ELM Libraries carry the options they were translated with, so this does not need to be specified. If the options are not specified, the translation options identified here are used.

A reference to a contained Parameters resource that specifies versions of canonical dependencies (i.e. pinned canonicals) that SHOULD be used for canonical references from artifacts in the manifest. The most common usage of this is specifying the version of a code system that SHOULD be used for expansion when the value set definition does not specify a code system version.

The manifest parameters are most commonly used to provide parameters for value set expansion. In source content (i.e. draft or unreleased content that is under development), the manifest parameters typically contains only pinned canonicals for major code systems. However, in released content, the manifest parameters contains pinned versions of canonical dependencies referenced without a specific version by the artifacts in the manifest library.

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

A reference to a contained Parameters resource that specifies versions of canonical dependencies (i.e. pinned canonicals) that were explicitly specified as input parameters by the authors. This is typically, but not always, used to specify the versions of external code systems such as SNOMED and LOINC.

The input parameters are captured as part of the release process to support distinguishing between canonical dependencies in the expansion parameters that were pinned by authors versus by the release/pinning process.

An Extension

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

A reference to a contained Parameters resource that specifies configuration for determining where artifact content can be accessed, based on the canonical url of the artifact.

The endpoint configuration is used to specify where consumers can download source of truth content for the artifacts referenced by this manifest. For a complete package, this is informational, but for a partial package, or when consumers only have the manifest, this information provides a way to determine where to access artifact content. For example, this information can be used to describe a preferred terminology server for the value sets referenced by an artifact. For more information on how this configuration information is used, see the Artifact Endpoint Configurable Operation Profile.

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

A reference to a contained OperationOutcome that provides any information, warning, or error messages that were encountered while packaging the artifact. Each issue encountered is recorded as a new issue element in the OperationOutcome, with an expression that traces to the resource that produced the message through the outcome manifest.

As an example, if a ValueSet cannot be expanded, the ValueSet may still be included as a component in the resulting Outcome Manifest, with an issue in the OperationOutcome indicating the value set could not be expanded. The expression of the issue would look something like: relatedArtifact.where(type='composed-of' and resource='http://example.org/fhir/ValueSet/123|1.0.0')

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

The status of this library. Enables tracking the life-cycle of the content.

Allows filtering of libraries that are appropriate for use vs. not.

The lifecycle status of an artifact.

Identifies the type of library such as a Logic Library, Model Definition, Asset Collection, or Module Definition.

The type of knowledge asset this library contains.

Related artifacts such as additional documentation, justification, or bibliographic references.

Each related artifact is either an attachment, or a reference to another resource, but not both.

Libraries must be able to provide enough information for consumers of the content (and/or interventions or results produced by the content) to be able to determine and understand the justification for and evidence in support of the content.

A canonical resource (such as a Library, CodeSystem, or ValueSet) that is part of the manifest.

This is the full list of component artifacts. Each component may be either a specific artifact (such as a Library, ValueSet, or Measure), or it may itself be an artifact manifest (i.e. a Library conforming to this profile) to allow manifest information (dependency version binding) to be specified per artifact, rather than requiring it all to be specified at the root level of the manifest).

Manifests must be able to unambiguously specify the set of components that make up the artifact collection. The version of each component SHALL be included in the canonical reference to the component.

To provide an indication of whether or not a referenced artifact is owned in context of the referencing artifact and therefore if it's lifecycle is managed in that context.

An intended usage context associated with the dependency on which it appears. When the dependency is packaged, this usageContext will be applied to the packaged artifact.

The type of relationship to the related artifact.

The type of relationship to the related artifact.

A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.

The related resource, such as a library, value set, profile, or other knowledge resource.

If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.

If the reference is to a non-canonical-artifact, this extension is used to provide a canonical-like reference as a uri (e.g. http://example.org/fhir/Group/example|1.0.0).

An Extension

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Because the type of an artifact cannot be reliably inferred from the uri, this element allows the type of the artifact to be specified

Knowing the actual type of the target of a canonical resource allows for improved processing of knowledge artifacts, but this information cannot be reliably inferred from the canonical URL, the URL must be resolved. This extension can be used to provide this information to facilitate dependency processing.

Because the type of an artifact cannot be reliably inferred from the canonical url, this element specifies the type of artifact.

Knowing the actual type of the target of a canonical resource allows for improved processing of knowledge artifacts, but this information cannot be reliably inferred from the canonical URL, the URL must be resolved. This extension can be used to provide this information to facilitate dependency processing.

A canonical resource (such as a Library, CodeSystem, or ValueSet) referenced by any artifact in the release, or any dependency of any artifact in the release, recursively.

This is the full list of dependencies of all artifacts used in the specification.

Artifacts must be able to unambiguously specify the versions of all dependencies used by artifacts in a specification. The version of each dependency SHALL be included in the canonical reference to the dependency.

An intended usage context associated with the dependency on which it appears. When the dependency is packaged, this usageContext will be applied to the packaged artifact.

Allows for the source of the dependency to be recorded. This extension may appear on the dependency any number of times, once for each unique originating source for the given dependency.

Indicates what role(s) the dependency is playing. Dependencies can play multiple roles. A dependency that does not state any roles is assumed to play the default role (i.e. there is no need to state that a dependency plays the default role, but the code is used in the include parameter to indicate whether default dependencies are included in a package).

Specifies the package in which an artifact is or was included.

The type of relationship to the related artifact.

The type of relationship to the related artifact.

A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.

The related resource, such as a library, value set, profile, or other knowledge resource.

If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.

If the reference is to a non-canonical-artifact, this extension is used to provide a canonical-like reference as a uri (e.g. http://example.org/fhir/Group/example|1.0.0).

An Extension

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Because the type of an artifact cannot be reliably inferred from the uri, this element allows the type of the artifact to be specified

Knowing the actual type of the target of a canonical resource allows for improved processing of knowledge artifacts, but this information cannot be reliably inferred from the canonical URL, the URL must be resolved. This extension can be used to provide this information to facilitate dependency processing.

Because the type of an artifact cannot be reliably inferred from the canonical url, this element specifies the type of artifact.

Knowing the actual type of the target of a canonical resource allows for improved processing of knowledge artifacts, but this information cannot be reliably inferred from the canonical URL, the URL must be resolved. This extension can be used to provide this information to facilitate dependency processing.

The content of the library as an Attachment. The content may be a reference to a url, or may be directly embedded as a base-64 string. Either way, the contentType of the attachment determines how to interpret the content.

Represents an artifact manifest library, providing complete dependency and usage information for an artifact or collection of artifacts. Artifact manifests are used throughout the content development lifecycle to establish version bindings for unversioned canonical references. Prior to release of the artifact(s), the manifest establishes the expansion rules such as code system versions used for expansion of value sets while artifacts are being authored. As part of release, the manifest is used to provide a complete dependency listing, as well as complete binding for all unversioned dependencies referenced in the artifacts so that canonical references can be reliably resolved, ensuring the stability of value set expansions used for evaluation of the artifacts.

Prior to release, artifact(s) should specify code system versions to support stable expansion of value sets during the development phase (also called an expansion profile). Post release, the artifact(s) will specify pinned canonical references for any unversioned canonical references to ensure reliable expansion of value sets. Provisional codes can be specified using the code system version mechanism (i.e. it is not the case that only one code system version can be specified per code system in an expand, and a manifest).

A manifest library must be able to describe the logic definitions it uses.

A reference to a contained Parameters resource that specifies versions of canonical dependencies (i.e. pinned canonicals) that SHOULD be used for canonical references from artifacts in the manifest. The most common usage of this is specifying the version of a code system that SHOULD be used for expansion when the value set definition does not specify a code system version.

The manifest parameters are most commonly used to provide parameters for value set expansion. In source content (i.e. draft or unreleased content that is under development), the manifest parameters typically contains only pinned canonicals for major code systems. However, in released content, the manifest parameters contains pinned versions of canonical dependencies referenced without a specific version by the artifacts in the manifest library.

A reference to a contained Parameters resource that specifies versions of canonical dependencies (i.e. pinned canonicals) that were explicitly specified as input parameters by the authors. This is typically, but not always, used to specify the versions of external code systems such as SNOMED and LOINC.

The input parameters are captured as part of the release process to support distinguishing between canonical dependencies in the expansion parameters that were pinned by authors versus by the release/pinning process.

A reference to a contained Parameters resource that specifies configuration for determining where artifact content can be accessed, based on the canonical url of the artifact.

The endpoint configuration is used to specify where consumers can download source of truth content for the artifacts referenced by this manifest. For a complete package, this is informational, but for a partial package, or when consumers only have the manifest, this information provides a way to determine where to access artifact content. For example, this information can be used to describe a preferred terminology server for the value sets referenced by an artifact. For more information on how this configuration information is used, see the Artifact Endpoint Configurable Operation Profile.

A reference to a contained OperationOutcome that provides any information, warning, or error messages that were encountered while packaging the artifact. Each issue encountered is recorded as a new issue element in the OperationOutcome, with an expression that traces to the resource that produced the message through the outcome manifest.

As an example, if a ValueSet cannot be expanded, the ValueSet may still be included as a component in the resulting Outcome Manifest, with an issue in the OperationOutcome indicating the value set could not be expanded. The expression of the issue would look something like: relatedArtifact.where(type='composed-of' and resource='http://example.org/fhir/ValueSet/123|1.0.0')

A canonical resource (such as a Library, CodeSystem, or ValueSet) that is part of the manifest.

This is the full list of component artifacts. Each component may be either a specific artifact (such as a Library, ValueSet, or Measure), or it may itself be an artifact manifest (i.e. a Library conforming to this profile) to allow manifest information (dependency version binding) to be specified per artifact, rather than requiring it all to be specified at the root level of the manifest).

Manifests must be able to unambiguously specify the set of components that make up the artifact collection. The version of each component SHALL be included in the canonical reference to the component.

If the reference is to a non-canonical-artifact, this extension is used to provide a canonical-like reference as a uri (e.g. http://example.org/fhir/Group/example|1.0.0).

Because the type of an artifact cannot be reliably inferred from the uri, this element allows the type of the artifact to be specified

Because the type of an artifact cannot be reliably inferred from the canonical url, this element specifies the type of artifact.

A canonical resource (such as a Library, CodeSystem, or ValueSet) referenced by any artifact in the release, or any dependency of any artifact in the release, recursively.

This is the full list of dependencies of all artifacts used in the specification.

Artifacts must be able to unambiguously specify the versions of all dependencies used by artifacts in a specification. The version of each dependency SHALL be included in the canonical reference to the dependency.

Allows for the source of the dependency to be recorded. This extension may appear on the dependency any number of times, once for each unique originating source for the given dependency.

If the reference is to a non-canonical-artifact, this extension is used to provide a canonical-like reference as a uri (e.g. http://example.org/fhir/Group/example|1.0.0).

Because the type of an artifact cannot be reliably inferred from the uri, this element allows the type of the artifact to be specified

Because the type of an artifact cannot be reliably inferred from the canonical url, this element specifies the type of artifact.

Represents an artifact manifest library, providing complete dependency and usage information for an artifact or collection of artifacts. Artifact manifests are used throughout the content development lifecycle to establish version bindings for unversioned canonical references. Prior to release of the artifact(s), the manifest establishes the expansion rules such as code system versions used for expansion of value sets while artifacts are being authored. As part of release, the manifest is used to provide a complete dependency listing, as well as complete binding for all unversioned dependencies referenced in the artifacts so that canonical references can be reliably resolved, ensuring the stability of value set expansions used for evaluation of the artifacts.

Prior to release, artifact(s) should specify code system versions to support stable expansion of value sets during the development phase (also called an expansion profile). Post release, the artifact(s) will specify pinned canonical references for any unversioned canonical references to ensure reliable expansion of value sets. Provisional codes can be specified using the code system version mechanism (i.e. it is not the case that only one code system version can be specified per code system in an expand, and a manifest).

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

The base language in which the resource is written.

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

A human language.

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

An Extension

Indicates that the given code is directly referenced by artifact logic (e.g. as a direct-reference code in CQL). Terminology dependencies used in logic can be collected and reported, typically using the relatedArtifact element with a type of depends-on. However, direct-reference codes cannot be represented in the relatedArtifact element, so this extension provides a means to support communicating direct-reference code dependencies of knowledge artifacts. As with value set dependencies, direct-reference codes may be the terminology target of a data requirement.

Represents a specific logic definition used by the artifact. When logic is referenced from knowledge artifacts, this extension allows each referenced definition to be represented independently so that consumers know which specific expressions are being referenced (i.e. not all expressions in a given library are always used), as well as allows processing applications (such as narrative generation) to easily surface the definitions to provide capabilities such as navigation.

A manifest library must be able to describe the logic definitions it uses.

Specifies a parameters (contained) resource that identifies the options for the CQL-to-ELM translator associated with the CQL content.

When this extension is used with a specific CQL library, it indicates the options that are to be used to translate the CQL to ELM. ELM Libraries carry the options they were translated with, so this does not need to be specified. If the options are not specified, the translation options identified here are used.

A reference to a contained Parameters resource that specifies versions of canonical dependencies (i.e. pinned canonicals) that SHOULD be used for canonical references from artifacts in the manifest. The most common usage of this is specifying the version of a code system that SHOULD be used for expansion when the value set definition does not specify a code system version.

The manifest parameters are most commonly used to provide parameters for value set expansion. In source content (i.e. draft or unreleased content that is under development), the manifest parameters typically contains only pinned canonicals for major code systems. However, in released content, the manifest parameters contains pinned versions of canonical dependencies referenced without a specific version by the artifacts in the manifest library.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

A reference to a contained Parameters resource that specifies versions of canonical dependencies (i.e. pinned canonicals) that were explicitly specified as input parameters by the authors. This is typically, but not always, used to specify the versions of external code systems such as SNOMED and LOINC.

The input parameters are captured as part of the release process to support distinguishing between canonical dependencies in the expansion parameters that were pinned by authors versus by the release/pinning process.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

A reference to a contained Parameters resource that specifies configuration for determining where artifact content can be accessed, based on the canonical url of the artifact.

The endpoint configuration is used to specify where consumers can download source of truth content for the artifacts referenced by this manifest. For a complete package, this is informational, but for a partial package, or when consumers only have the manifest, this information provides a way to determine where to access artifact content. For example, this information can be used to describe a preferred terminology server for the value sets referenced by an artifact. For more information on how this configuration information is used, see the Artifact Endpoint Configurable Operation Profile.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

A reference to a contained OperationOutcome that provides any information, warning, or error messages that were encountered while packaging the artifact. Each issue encountered is recorded as a new issue element in the OperationOutcome, with an expression that traces to the resource that produced the message through the outcome manifest.

As an example, if a ValueSet cannot be expanded, the ValueSet may still be included as a component in the resulting Outcome Manifest, with an issue in the OperationOutcome indicating the value set could not be expanded. The expression of the issue would look something like: relatedArtifact.where(type='composed-of' and resource='http://example.org/fhir/ValueSet/123|1.0.0')

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

An absolute URI that is used to identify this library when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this library is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the library is stored on different servers.

Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version.

The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in Technical and Business Versions.

In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the meta.source element to indicate where the current master source of the resource can be found.

Allows the library to be referenced by a single globally unique identifier.

A formal identifier that is used to identify this library when it is represented in other formats, or referenced in a specification, model, design or an instance. e.g. CMS or NQF identifiers for a measure artifact. Note that at least one identifier is required for non-experimental active artifacts.

Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this library outside of FHIR, where it is not possible to use the logical URI.

Allows externally provided and/or usable business identifiers to be easily associated with the module.

The identifier that is used to identify this version of the library when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the library author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence. To provide a version consistent with the Decision Support Service specification, use the format Major.Minor.Revision (e.g. 1.0.0). For more information on versioning knowledge assets, refer to the Decision Support Service specification. Note that a version is required for non-experimental active artifacts.

There may be different library instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the library with the format [url]|[version].

A natural language name identifying the library. This name should be usable as an identifier for the module by machine processing applications such as code generation.

The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.

Support human navigation and code generation.

A short, descriptive, user-friendly title for the library.

This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.

An explanatory or alternate title for the library giving additional information about its content.

The status of this library. Enables tracking the life-cycle of the content.

Allows filtering of libraries that are appropriate for use vs. not.

The lifecycle status of an artifact.

A Boolean value to indicate that this library is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.

Allows filtering of librarys that are appropriate for use versus not.

Enables experimental content to be developed following the same lifecycle that would be used for a production-level library.

Identifies the type of library such as a Logic Library, Model Definition, Asset Collection, or Module Definition.

The type of knowledge asset this library contains.

A code or group definition that describes the intended subject of the contents of the library.

The possible types of subjects for a library (E.g. Patient, Practitioner, Organization, Location, etc.).

The date (and optionally time) when the library was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the library changes.

Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the library. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

The name of the organization or individual that published the library.

Usually an organization but may be an individual. The publisher (or steward) of the library is the organization or individual primarily responsible for the maintenance and upkeep of the library. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the library. This item SHOULD be populated unless the information is available from context.

Helps establish the "authority/credibility" of the library. May also allow for contact.

Contact details to assist a user in finding and communicating with the publisher.

May be a web site, an email address, a telephone number, etc.

A free text natural language description of the library from a consumer's perspective.

This description can be used to capture details such as why the library was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the library as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the library is presumed to be the predominant language in the place the library was created).

The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate library instances.

When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

Assist in searching for appropriate content.

A legal or geographic region in which the library is intended to be used.

It may be possible for the library to be used in jurisdictions other than those for which it was originally designed or intended.

Countries and regions within which this artifact is targeted for use.

Explanation of why this library is needed and why it has been designed as it has.

This element does not describe the usage of the library. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this library.

A detailed description of how the library is used from a clinical perspective.

A copyright statement relating to the library and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the library.

Consumers must be able to determine any legal restrictions on the use of the library and/or its content.

The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage.

The 'date' element may be more recent than the approval date because of minor changes or editorial corrections.

The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.

If specified, this date follows the original approval date.

Gives a sense of how "current" the content is. Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant.

The period during which the library content was or is planned to be in active use.

The effective period for a library determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015.

Allows establishing a transition before a resource comes into effect and also allows for a sunsetting process when new versions of the library are or are expected to be used instead.

Descriptive topics related to the content of the library. Topics provide a high-level categorization of the library that can be useful for filtering and searching.

High-level categorization of the definition, used for searching, sorting, and filtering.

Repositories must be able to determine how to categorize the library so that it can be found by topical searches.

An individiual or organization primarily involved in the creation and maintenance of the content.

An individual or organization primarily responsible for internal coherence of the content.

An individual or organization primarily responsible for review of some aspect of the content.

An individual or organization responsible for officially endorsing the content for use in some setting.

Related artifacts such as additional documentation, justification, or bibliographic references.

Each related artifact is either an attachment, or a reference to another resource, but not both.

Libraries must be able to provide enough information for consumers of the content (and/or interventions or results produced by the content) to be able to determine and understand the justification for and evidence in support of the content.

A canonical resource (such as a Library, CodeSystem, or ValueSet) that is part of the manifest.

This is the full list of component artifacts. Each component may be either a specific artifact (such as a Library, ValueSet, or Measure), or it may itself be an artifact manifest (i.e. a Library conforming to this profile) to allow manifest information (dependency version binding) to be specified per artifact, rather than requiring it all to be specified at the root level of the manifest).

Manifests must be able to unambiguously specify the set of components that make up the artifact collection. The version of each component SHALL be included in the canonical reference to the component.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

To provide an indication of whether or not a referenced artifact is owned in context of the referencing artifact and therefore if it's lifecycle is managed in that context.

An intended usage context associated with the dependency on which it appears. When the dependency is packaged, this usageContext will be applied to the packaged artifact.

The type of relationship to the related artifact.

The type of relationship to the related artifact.

A short label that can be used to reference the citation from elsewhere in the containing artifact, such as a footnote index.

A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.

A bibliographic citation for the related artifact. This text SHOULD be formatted according to an accepted citation format.

Additional structured information about citations should be captured as extensions.

A url for the artifact that can be followed to access the actual content.

If a document or resource element is present, this element SHALL NOT be provided (use the url or reference in the Attachment or resource reference).

The document being referenced, represented as an attachment. This is exclusive with the resource element.

The related resource, such as a library, value set, profile, or other knowledge resource.

If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.

unique id for the element within a resource (for internal references)

An Extension

If the reference is to a non-canonical-artifact, this extension is used to provide a canonical-like reference as a uri (e.g. http://example.org/fhir/Group/example|1.0.0).

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

unique id for the element within a resource (for internal references)

An Extension